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Comprehensive chronic care

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https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#1
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28741243/the-pharmacogenomic-and-metabolomic-predictors-of-ace-inhibitor-and-angiotensin-ii-receptor-blocker-effectiveness-and-safety
#2
Hania K Flaten, Andrew A Monte
Hypertension (HTN) is the most common chronic disease in the USA. Hypertensive patients frequently require repeat primary care visits to find an effective drug or drug combination to control their disease. Currently, patients are prescribed drugs for HTN based on race, age, and comorbidities and although the current guidelines are reasonable starting points for prescribing, 50% of hypertensive patients still fail to achieve target blood pressures. Despite numerous strategies to improve compliance, drug effectiveness, and optimization of initial drug choice, effectiveness has remained largely unchanged over the past two decades...
July 24, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28737649/race-age-and-geography-impact-hepatitis-c-genotype-distribution-in-the-united-states
#3
Stuart C Gordon, Sheri Trudeau, Jia Li, Yueren Zhou, Loralee B Rupp, Scott D Holmberg, Anne C Moorman, Philip R Spradling, Eyasu Teshale, Joseph A Boscarino, Yihe G Daida, Mark A Schmidt, Mei Lu
GOALS: To determine the impact of geography and patient characteristics on hepatitis C virus (HCV) genotype and subtype distribution in a large sample of patients under routine clinical care BACKGROUND:: HCV genotype impacts disease course and response to treatment. Although several studies have reported genotype distribution within specific US populations, there are no comprehensive descriptions in large, geographically diverse cohorts. STUDY: Using data from the Chronic Hepatitis Cohort Study, we present the distribution of HCV genotypes (GT) and subtypes (ST) among a racially diverse cohort of over 8000 HCV-infected patients from four large US health systems...
July 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28736211/applying-contemporary-neuroscience-in-exercise-interventions-for-chronic-spinal-pain-treatment-protocol
#4
Malfliet Anneleen, Kregel Jeroen, Meeus Mira, Cagnie Barbara, Roussel Nathalie, Dolphens Mieke, Danneels Lieven, Nijs Jo
BACKGROUND: Nonspecific chronic spinal pain is a common problem within the chronic pain population and is characterized by high social, economic and personal impact. To date, therapists are still struggling in adequately treating these types of patients, as seen in the small and short-term benefits of frequently applied primary care treatments. It is remarkable that despite the well-documented presence of abnormalities in central nociceptive processing in nonspecific chronic spinal pain patients, the implementation of this knowledge in clinical practice is still nearly non-existent...
July 8, 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28734479/the-internal-medicine-of-the-21st-century-organizational-and-operational-standards
#5
E Casariego-Vales, A Zapatero-Gaviria, F J Elola-Somoza
The Spanish Society of Internal Medicine has developed a consensus document on the standards and recommendations that they consider essential to the organisation of internal medicine units for conducting their activities efficiently and with high quality. We defined 3 groups of key processes: the care of acutely ill adult patients, the comprehensive care of complex chronic patients and the examination of a patient with a difficult diagnosis and no organ-specific disease. As support processes, we identified the structure and operation of the Internal Medicine units...
July 19, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28732838/causes-of-misdiagnosis-of-chronic-obstructive-pulmonary-disease-a-systematic-scoping-review
#6
REVIEW
Stine Hangaard, Tina Helle, Carl Nielsen, Ole K Hejlesen
BACKGROUND: Chronic obstructive pulmonary disease (COPD) has serious implications at both the individual and the societal level. It is crucial that COPD is diagnosed correctly to ensure provision of the right treatment. However, the current diagnostic procedures may lead to misdiagnosis. AIM: The aim of this scoping review was to disseminate knowledge about potential causes of misdiagnosis of COPD. METHODS: A systematic, comprehensive search was performed in PubMed, Embase and Cinahl...
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28729620/self-management-behaviour-and-support-among-primary-care-copd-patients-cross-sectional-analysis-of-data-from-the-birmingham-chronic-obstructive-pulmonary-disease-cohort
#7
Ainee Khan, Andrew P Dickens, Peymane Adab, Rachel E Jordan
Self-management support for chronic obstructive pulmonary disease (COPD) patients is recommended by UK national guidelines, but extent of implementation is unknown. We aimed to describe self-management behaviour and support among COPD patients and explore behaviour associated with having a self-management plan. We undertook cross-sectional analysis of self-reported data from diagnosed COPD patients in the Birmingham COPD Cohort study. Questionnaire items relevant to self-management behaviour, knowledge of COPD, receipt of self-management plans and advice from healthcare professionals were examined...
July 20, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28728525/gender-differences-in-causes-of-death-among-persons-with-hiv-aids-in-san-francisco-california-1996-2013
#8
Nancy A Hessol, Sandra K Schwarcz, Ling Chin Hsu, Martha Shumway, Edward L Machtinger
The objective was to examine gender differences in causes of death using the San Francisco HIV/AIDS and death registries. Data from San Francisco residents diagnosed with HIV/AIDS who died from 1996 to 2013 were analyzed. Age, race/ethnicity, year, and gender-adjusted standardized mortality ratios and Poisson 95% confidence intervals were calculated for underlying causes of death. Among the 6268 deaths, deaths attributed to drug use, mental disorders due to substance use, cerebrovascular disease, chronic obstructive pulmonary disease, renal disease, and septicemia were more likely among women than among men...
January 1, 2017: International Journal of STD & AIDS
https://www.readbyqxmd.com/read/28726061/advances-in-psychotherapy-for-depressed-older-adults
#9
REVIEW
Patrick J Raue, Amanda R McGovern, Dimitris N Kiosses, Jo Anne Sirey
PURPOSE OF REVIEW: We review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings. RECENT FINDINGS: Recent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including COPD, heart failure, Parkinson's disease, stroke and other acute conditions, cognitive impairment, and suicide risk...
September 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/28724299/spirituality-in-adolescent-patients
#10
Meaghann S Weaver, Dale Wratchford
Adolescence, the transition between childhood and adulthood, represents a time of rapid biological, neurocognitive, and psychosocial changes. These changes have important implications for the development and evolution of adolescent spirituality, particularly for adolescents with chronic or life-limiting illnesses. To contribute positively to adolescent spiritual formation, palliative care teams benefit from understanding the normative changes expected to occur during adolescence. This paper provides a narrative review of adolescent spirituality while recognizing the role of religious, familial, and cultural influences on spiritual development during the teenage years...
July 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28718661/anxiety-and-self-care-behaviour-in-patients-with-chronic-systolic-heart-failure-a-multivariate-model
#11
Thomas Müller-Tasch, Bernd Löwe, Nicole Lossnitzer, Lutz Frankenstein, Tobias Täger, Markus Haass, Hugo Katus, Jobst-Hendrik Schultz, Wolfgang Herzog
BACKGROUND: While comprehensive evidence exists regarding negative effects of depression on self-care behaviours in patients with chronic heart failure (CHF), the relation between anxiety and self-care behaviours in patients with CHF is not clear. The aim of this study was to analyse the interactions between anxiety, depression and self-care behaviours in patients with CHF. METHODS: The self-care behaviour of CHF outpatients was measured using the European Heart Failure Self-care Behaviour Scale (EHFScBS)...
July 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28718607/-interdisciplinarity-for-obese-patient-global-management
#12
Frank Habicht, Marie-Luce Guillermin-Spahr, Elisabetta Bobbioni-Harsch
Obesity is a chronic illness involving serious somatic comorbidities and psychological disorders. Furthermore, obese patients often suffer from personal and / or socio-cultural problems. Taken together these elements amount to a complex illness requiring comprehensive patient care and hence an interdisciplinary approach aimed at integrating and coordinating the interventions of the different health professionals. Through various initiatives, the Interdisciplinary group for the treatment of obesity (GITO) endeavours to apply and promote an interdisciplinary approach both in clinical practice and in the debate on the problems relating to obesity...
March 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28716466/chronic-low-back-pain-patients-walk-with-locally-altered-spinal-kinematics
#13
Guillaume Christe, François Kade, Brigitte M Jolles, Julien Favre
Various studies have reported alterations of spinal kinematics in patients with chronic low back pain (CLBP) during gait. However, while recent findings stressed the importance of multi-segment analysis, most of prior gait studies modelled the lumbar spine as one segment, when it was not the entire trunk that was considered as a single segment. Therefore, there is a need for comprehensive multi-segment research that could improve our understanding of CLBP pathomechanism and thus possibly contribute to better care for CLBP...
July 5, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#14
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28712578/outcomes-readmissions-and-costs-in-transfemoral-and-alterative-access-transcatheter-aortic-valve-replacement-in-the-us-medicare-population
#15
Fenton H McCarthy, Danielle D Spragan, Danielle Savino, Taylor Dibble, Ashley C Hoedt, Katherine M McDermott, Joseph E Bavaria, Howard C Herrmann, Saif Anwaruddin, Jay Giri, Wilson Y Szeto, Peter W Groeneveld, Nimesh D Desai
OBJECTIVE: To comprehensively evaluate and compare utilization, outcomes, and especially costs of transfemoral (TF), transapical (TA), and transaortic (TAO) transcatheter aortic valve replacement (TAVR). METHODS: All Medicare fee-for-service patients undergoing TF (n = 4065), TA (n = 691), or TAO (n = 274) TAVR between January 1, 2011, and November 30, 2012, were identified using Health Care Procedure Classification Codes present on Medicare claims. Hospital charges from Medicare claims were converted to costs using hospital-specific Medicare cost-to-charge ratios...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28707421/safer-and-more-appropriate-opioid-prescribing-a-large-healthcare-system-s-comprehensive-approach
#16
Jan L Losby, Joel D Hyatt, Michael H Kanter, Grant Baldwin, Denis Matsuoka
RATIONALE, AIMS, AND OBJECTIVES: The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long-term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination through electronic health record integration...
July 14, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28706720/endotype-driven-treatment-in-chronic-upper-airway-diseases
#17
REVIEW
Glynnis De Greve, Peter W Hellings, Wytske J Fokkens, Benoit Pugin, Brecht Steelant, Sven F Seys
Rhinitis and rhinosinusitis are the two major clinical entities of chronic upper airway disease. Chronic rhinosinusitis (CRS) and allergic rhinitis (AR) affect respectively up to 10 and 30% of the total population, hence being associated with an important socio-economic burden. Different phenotypes of rhinitis and CRS have been described based on symptom severity and duration, atopy status, level of control, comorbidities and presence or absence of nasal polyps in CRS. The underlying pathophysiological mechanisms are diverse, with different, and sometimes overlapping, endotypes being recognized...
2017: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/28706444/patients-conceptions-of-their-own-influence-on-good-treatment-response-to-biological-therapy-in-chronic-inflammatory-arthritis
#18
Ingrid Larsson
BACKGROUND: Biological therapies are common in the treatment of patients with chronic inflammatory arthritis (CIA). However, despite the fact that many patients respond well to their biological therapies, there are still a number of nonresponders. In order to design the best care for patients, it is important to understand how they conceive their own role in their treatment response. OBJECTIVE: To explore how patients with CIA conceive their own influence on a good treatment response to biological therapy...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28699283/prospective-evaluation-of-chronic-organ-damage-in-adult-sickle-cell-patients-a-seven-year-follow-up-study
#19
Charlotte F J van Tuijn, Marein Schimmel, Eduard J van Beers, Erfan Nur, Bart J Biemond
Organ damage in sickle cell disease (SCD) is a crucial determinant for disease severity and prognosis. In a previous study, we analyzed the prevalence of SCD-related organ damage and complications in adult sickle cell patients. We now describe a seven-year follow-up of this cohort. All patients from the primary analysis in 2006 (n=104), were included for follow-up. Patients were screened for SCD-related organ damage and complications (microalbuminuria, renal failure, elevated tricuspid regurgitation flow velocity (TRV) (≥2...
July 11, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28699096/hepatitis-c-cascade-of-care-among-pregnant-women-on-opioid-agonist-pharmacotherapy-attending-a-comprehensive-prenatal-program
#20
Kimberly Page, Lawrence Leeman, Steven Bishop, Sandra Cano, Ludmila N Bakhireva
Background Given the large increases in opioid use among pregnant women and associations with hepatitis C virus (HCV) infection, screening pregnant women who are on (opioid agonist) pharmacotherapy for HCV infection has potential to inform medical care for these mothers as well as their newborns. We investigated the HCV testing cascade among pregnant women on pharmacotherapy in order to describe exposure and infection rates and to identify opportunities that would improve care. Methods Secondary analyses of laboratory results were performed for HCV testing, including anti-HCV, viremia (RNA) and genotype...
July 11, 2017: Maternal and Child Health Journal
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